Surgical cutting instrument

Abstract

A surgical cutting instrument includes movable and stationary jaws at a distal end of an elongate probe formed of an outer tubular member and an inner tubular member rotatable therein, a cam and cam follower at the distal end for translating rotary motion of the inner member to pivotal motion of the movable jaw to cut bodily tissue. The stationary jaw has an opening in the bottom thereof to allow cut bodily tissue to exit to a location external of the surgical cutting instrument, and a suction passage along the inner member terminates at a mouth disposed relative to the cam such that the cam contacts and comminutes cut bodily tissue before the tissue enters the mouth and is aspirated through the suction passage.

What is claimed is: 
     
       1. A surgical cutting and aspirating instrument comprising elongate probe means having a distal end, a proximal end adapted to communicate with a vacuum source, and suction passage means extending between said distal end and said proximal end for aspirating cut tissue;   tissue cutting means disposed at said distal end of said probe means for cutting bodily tissue including a movable cutting member; and   tissue comminuting means disposed at said distal end of said probe means and movable in a different path relative to said cutting member for comminuting bodily tissue cut by said tissue cutting means prior to aspiration of the cut tissue through said suction passage means.   
     
     
       2. A surgical cutting and aspirating instrument as recited in claim 1 wherein said tissue comminuting means drives said tissue cutting means. 
     
     
       3. A surgical cutting and aspirating instrument as recited in claim 1 wherein said tissue cutting means includes a stationary jaw and said cutting member includes a movable jaw mounted for movement relative to said stationary jaw for cutting bodily tissue. 
     
     
       4. A surgical cutting and aspirating instrument as recited in claim 3 wherein said movable jaw is pivotally mounted on said stationary jaw and said probe means includes a first elongate member having a distal end carrying said stationary and a second elongate member extending along said first elongate member and having a distal end coupled with said movable jaw to pivot said movable jaw to create a cutting action between said stationary jaw and movable jaws. 
     
     
       5. A surgical cutting and aspirating instrument as recited in claim 4 wherein said first elongate member is tubular. 
     
     
       6. A surgical cutting and aspirating instrument as recited in claim 5 wherein said second elongate member is tubular and extends within said first elongate member to define said suction passage means. 
     
     
       7. A surgical cutting and aspirating instrument as recited in claim 6 wherein said second elongate member terminates to a mouth spaced from said movable jaw and said tissue comminuting means is disposed between said movable jaw and said mouth. 
     
     
       8. A surgical cutting and aspirating instrument as recited in claim 7 wherein said comminuting means includes means coupling said second elongate member with said movable jaw. 
     
     
       9. A surgical cutting instrument for use with a drive unit having a rotatably driven output comprising an outer elongate tubular member having a longitudinal axis, a proximal end adapted to be coupled with the drive unit and a distal end;   a stationary cutting jaw disposed at said distal end of said outer member including a cutting chamber therein having a rim defining a cutting edge;   an inner elongate member disposed within said outer member having a proximal end adapted to be rotatably driven by the output of the drive unit and a distal end disposed adjacent said distal end of said outer member;   a movable cutting jaw pivotally mounted on said stationary jaw to pivot on an axis angularly disposed relative to said longitudinal axis and having a cutting edge movable past said cutting edge of said stationary jaw to cut bodily tissue;   motion translating means coupled with said distal end of said inner member and said movable jaw for translating rotating movement of said inner member to pivotal movement of said movable jaw.   
     
     
       10. A surgical cutting instrument as recited in claim 9 wherein said motion translating means includes first cam means carried on said distal end of said inner member to rotate therewith and second cam means carried on said movable jaw and coupled with said first cam means to cause pivoting movement of said movable jaw. 
     
     
       11. A surgical cutting instrument as recited in claim 10 wherein said movable jaw includes a distal end carrying said cutting edge, a proximal end and a midsection disposed between said distal end and said proximal end and pivotally mounted in said cutting chamber, said first cam means includes a pin extending longitudinally from said distal end of said inner member at a position radially offset from the longitudinal axis thereof and said second cam means includes a recess in said proximal end of said movable jaw receiving said pin. 
     
     
       12. A surgical cutting instrument as recited in claim 11 wherein said movable jaw pivots on an axis transverse to the longitudinal axis of said outer member and said recess in said proximal end of said movable jaw extends transverse to the longitudinal axis of said outer member in parallel relation to said pivot axis. 
     
     
       13. A surgical cutting instrument as recited in claim 12 wherein said recess in said proximal end has an opening having a length extending in parallel relation to said pivot axis and a width extending transverse to said length, said length being greater than said width and said width being greater than the breadth of said pin whereby said movable jaw dwells at positions of extreme pivoting movement while said inner member continues to rotate. 
     
     
       14. A surgical cutting instrument as recited in claim 9 wherein said cutting edge of said stationary jaw is substantially U-shaped in plan view, said cutting edge of said movable jaw is substantially U-shaped in plan view and of a size to pass by said rim into said cutting chamber, and said stationary jaw has an opening formed therethrough opposite said rim to allow cut tissue to exit from said cutting chamber to a location external of said surgical cutting instrument. 
     
     
       15. A surgical cutting instrument for use with a drive unit having a rotatably driven output comprising an outer elongate tubular member having a proximal end adapted to be coupled with the drive unit and a distal end;   a stationary cutting jaw disposed at said distal end of said outer member including a cutting chamber having a rim defining a cutting edge;   an inner tubular elongate member disposed within said outer member having a proximal end adapted to be rotatably driven by the output of the drive unit and a distal end disposed adjacent said distal end of said outer member;   a movable cutting jaw pivotally mounted on said stationary jaw and having a cutting edge movable past said cutting edge of said stationary jaw to cut bodily tissue, said movable jaw including a distal end carrying said cutting edge, a proximal end and a midsection disposed between said distal end and said proximal end and pivotally mounted in said cutting chamber, said inner member defining a mouth at said distal end thereof proximally spaced from said movable jaw, said proximal end of said inner member being adapted to communicate with a vacuum source to created concentrated suction at said mouth to aspirate tissue cut with said surgical cutting instrument; and   motion translating means coupled with said distal end of said inner member and said movable jaw for translating rotating movement of said inner member to pivotal movement of said movable jaw, said motion translating means including a pin extending longitudinally from said distal end of said inner member at a position radially offset from the longitudinal axis thereof to rotate with said inner member and a recess in said proximal end of said movable jaw extending transverse to the longitudinal axis of said outer member in parallel relation to said pivot axis and receiving said pin to pivot said movable jaw on an axis transverse to the longitudinal axis of said outer member, said recess having a length extending in parallel relation to said pivot axis and a width extending transverse to said length, said length being greater than said width and said width being greater than the breadth of said pin whereby said movable jaw dwells at positions of extreme pivoting movement while said inner member continues to rotate.   
     
     
       16. A surgical cutting instrument for use with a drive unit having a rotatably driven output comprising an outer elongate tubular member having a proximal end adapted to be coupled with the drive unit and a distal end;   a stationary cutting jaw disposed at said distal end of said outer member including a cutting chamber having a rim defining a cutting edge;   an inner tubular elongate member disposed within said outer member having a proximal end adapted to be rotatably driven by the output of the drive unit and a distal end disposed adjacent said distal end of said outer member;   a movable cutting jaw pivotally mounted on said stationary jaw and having a cutting edge movable past said cutting edge of said stationary jaw to cut bodily tissue, said movable jaw including a distal end carrying said cutting edge, a proximal end and a midsection disposed between said distal end and said proximal end and pivotally mounted in said cutting chamber; and   motion translating means coupled with said distal end of said inner member and said movable jaw for translating rotating movement of said inner member to pivotal movement of said movable jaw, said motion translating means including a pin extending longitudinally from said distal end of said inner member at a position radially offset from the longitudinal axis thereof to rotate with said inner member and a recess in said proximal end of said movable jaw receiving said pin, said inner member defining a mouth at said distal end thereof adjacent said pin and proximally spaced from said proximal end of said movable jaw, said proximal end of said tubular inner member is adapted to communicate with a vacuum source to create concentrated suction at said mouth to aspirate tissue cut with said surgical cutting instrument, and said pin moves in a circular path in the space between said proximal end of said movable jaw and said mouth to cut tissue before the cut tissue enters said mouth for aspiration.   
     
     
       17. A surgical cutting instrument as recited in claim 16 wherein said stationary jaw has an aperture extending therethrough transversely to the longitudinal axis of said outer member to define said cutting chamber forward of said midsection of said movable jaw, to define a suction and comminuting chamber rearward of said midsection and to define openings in said stationary jaw opposite said rim and communicating with said cutting chamber and said comminuting and suction chamber whereby tissue cut by said cutting edges of said movable and stationary jaws passes through said cutting chamber and exits said stationary jaw through said opening communicating with said cutting chamber and said cut tissue is aspirated by passing through said opening communicating with said comminuting and suction chamber, through said comminuting and suction chamber where the cut tissue is contacted by said pin and through said mouth and said tubular inner member. 
     
     
       18. A surgical cutting instrument for use with a drive unit having a rotatably driven output comprising an outer elongate tubular member having a proximal end adapted to be coupled with the drive unit and a distal end;   a stationary cutting jaw disposed at said distal end of said outer member including a cutting chamber having a rim defining a cutting edge, said cutting edge being substantially U-shaped in plan view, said stationary jaw having an opening opposite said rim to allow cut tissue to exit from said cutting chamber to a location external of said surgical cutting instrument;   an inner elongate tubular member disposed within said outer member having a proximal end adapted to be rotatably driven by the output of the drive unit and a distal end disposed adjacent said distal end of said outer member, said inner member having a mouth disposed at said distal end thereof adjacent said opening;   a movable cutting jaw pivotally mounted on said stationary jaw and having a cutting edge movable past said cutting edge of said stationary jaw to cut bodily tissue, said cutting edge of said movable jaw being substantially U-shaped in plan view and of a size to pass by said rim into said cutting chamber;   motion translating means coupled with said distal end of said inner member and said movable jaw for translating rotating movement of said inner member to pivotal movement of said movable jaw; and   means adapted to communicate with a vacuum source to create suction at said mouth to cause the cut tissue to move through said mouth and said inner member for aspiration.   
     
     
       19. A surgical cutting and aspirating instrument comprising elongate probe means having a distal end, a proximal end adapted to communicate with a vacuum source, and suction passage means extending between said distal end and said proximal end for aspirating cut tissue; tissue cutting means disposed at said distal end of said probe means for cutting bodily tissue, said tissue cutting means including a stationary jaw and a movable jaw pivotally mounted on said stationary jaw for movement relative to said stationary jaw for cutting bodily tissue;   a first tubular elongate member having a distal end carrying said stationary jaw and a second tubular elongate member extending within said first elongate member to define said suction passage means, said second elongate member having a distal end coupled with said movable jaw to pivot said movable jaw to create a cutting action between said stationary jaw and said movable jaw, said second member terminating to a mouth spaced from said movable jaw, said second elongate member being rotatable in said first elongate member; and   tissue comminuting means disposed at said distal end of said probe means for comminuting bodily tissue cut by said tissue cutting means prior to aspiration of the cut tissue through said suction passage means, said tissue comminuting means being disposed between said movable jaw and said mouth and including cam means extending longitudinally from said mouth at a position radially offset from the longitudinal axis of said second elongate member to engage and pivot said movable jaw and to contact tissue prior to entry of the cut tissue into said mouth for aspiration.   
     
     
       20. A surgical cutting and aspirating instrument as recited in claim 19 wherein said movable jaw includes a distal end carrying a cutting edge, a proximal end having cam follower means engaging said cam means and a midsection disposed between said distal end and said proximal end, said stationary jaw has an aperture extending therethrough transversely to the longitudinal axis of said first elongate member to define a cutting chamber forward of said midsection of said movable jaw having a cutting edge therealong, to define a comminuting and suction chamber rearward of said midsection and to define an opening in said stationary jaw opposite said stationary jaw cutting edge and communicating with said cutting chamber and said comminuting and suction chamber whereby tissue cut by said cutting edges of said movable and stationary jaws passes through said cutting chamber and exits said stationary jaw through said opening communicating with said cutting chamber and said cut tissue is aspirated by passing through said opening communicating with said comminuting and suction chamber, through said comminuting and suction chamber where the cut tissue is contacted by said cam means and through said mouth and said second elongate inner member.